NHS England - blood donation if you are transgender

They test all donated blood for HIV, syphilis, hepatitis and HTLV, and possibly others. (They are also very clear that if you think you are at risk, you should not donate and go and get tested elsewhere.)

You're also restricted from donating if you have recently had injections, including stuff like dental painkillers, so that would mean people on certain treatments can't donate.

You can donate on some medications, if they're stable.

One third of HiV carriers in the UK are cisgender women. How many do you think are transwomen in comparison and who is most likely to be aware of their HiV status?

Yes, Catherina, I would certainly hope they would.

Cwenthryth thanks for your posts, really helpful.

Bergamotte - since donating blood is an altruistic act, I would expect trans men or women to mention the drugs they are taking. Wouldn't you?

The difference is really minor. There is no magical "man" blood and "woman" blood.

And anyone who has had a baby can donate blood (recommended is to wait 9 months after having given birth, or 3 months after weaning).

Many trans men may be turned away from donor clinics as their lesser haemoglobin levels will not meet the male standard

Any trans man who has been pregnant in the past (may have miscarried or given birth), may have antibodies in his blood that will pose a risk to a male recipient.

[quote CatherinaJTV]it's quite well described here

www.transfusionguidelines.org/dsg/wb/guidelines/ho005-hormone-replacement-therapy[/quote]
That entry does not mention cross-sex hormones.

It gives advice on HRT given for malignancy, menopause symptoms, erectile disfunction, and about growth hormones, but gives no mention of gender dysphoria.

I hope that anyone donating would declare all medication they are taking. There are many medications that don't stop you from donating- including hormonal contraceptives. But it is important the service knows what they are getting, so they can use the blood appropriately.

Donating blood is an altruistic act, not something you should do for your own validation.

(I'm using "you" in the general sense throughout this post; not directing it to any individual.)

it's quite well described here

www.transfusionguidelines.org/dsg/wb/guidelines/ho005-hormone-replacement-therapy

Whilst there has been a research paper it was inconclusive whether it was causation or correlation. Currently sex is not matched as part of the process when someone requires a transfusion. If this changes then obviously additional checks will need to be included. Does anyone know if it's even an issue? Does taking hormones preclude you from donating blood, many medications do.

Hb will be measured in each sample, so can be matched if and as needed, the donor will be asked for any medication they are taking at which the hrt would come up, so I really don't see where the problem is.

As Mr Spock would say " this is all highly illogical"

The 80s and 90s were 30-40 years ago, screening of blood products and understanding of HIV has come a long long long way since then - the blanket ban on all men who have sex with men donating has been a homophobic hangover for many many years now. It is absolutely right that it is now changing but way overdue. As I said a monogamous HIV-neg couple are zero risk and we have known that for decades, there was no reason to prevent those men donating other than prejudice.

I believe a transwoman donating with a Hb too low to pass on the male test but passes the female test, is highly likely to be absolutely fine, even if they still donate at the male frequency - because the cutoffs are set very conservatively anyway.

I believe the major risks to be considered here are (1) blood from transmen that have ever been pregnant being given to male recipients; and (2) that HIV does not care about someone’s gender identity when it comes to transmission risk. Tbh I doubt that the research has even been done yet on HIV risk and prevalence in various trans demographics, given the speed at which these demographics have developed and grown.

At the end of the day almost everything about safe blood donation relies on honesty from donors; important things such as waiting after tattoos or acupuncture, travel to at-risk destinations etc relies on self declaration, there is no way to independently verify these factors; so, given that we can expect that people who believe in gender ideology are going to declare their self-identified gender/sexuality rather than sex registered at birth - the blood service needs to manage this accordingly. I do believe it is still very important that “sex registered at birth” still be requested due to the increased risk to recipients of cross-sex female-to-male transfusions. But when it comes to risks around sexual history using terms such as man and woman will, unfortunately, be interpreted in different ways by different people dependent on their beliefs as to what those words mean, so the blood service have to manage those responses accordingly.

A well known GC trans woman was tweeting the other day about donating blood with a haemoglobin level acceptable in the women’s reference range, but not the men’s. Says would never be able to donate if the male range applied due to low iron. This person does acknowledge they are biologically male.

... which seems a bit unwise to me, that this is allowed by the service, rather than this person’s generosity in donating. will NHSBT be on the hook if they turn up with adverse health outcomes due to repeatedly donating with too low iron for their sex?

And also:

(from the guide my.blood.co.uk/knowledgebase/Index/T)

'Transgender Individuals

Sorry, but we need to have more information for us to answer your enquiry. To give you an answer we will need to speak to you. Please call our Donor Helpline on 0300 123 23 23, Monday to Friday, 9am to 7pm as we may need to transfer you to the Referral Team. '

Wow, they are quite blunt here:

Please keep donating, particularly if you are: male - men can donate more often than women

www.blood.co.uk/who-can-give-blood/

And even:

www.blood.co.uk/who-can-give-blood/why-men-should-donate-blood/

This is what they say about hormones:

'HRT : Hormone Replacement Therapy

If having investigations - please wait until these are finished.

If treatment due to malignancy - We are sorry but you are unable to donate.

If this is being used to treat symptoms of the menopause, for gender change or to prevent osteoporosis only - You may donate if taken by mouth, using patches or if using an implant all wounds must be healed with no infection and you feel well on the day.'

Whole thing beggar's belief!

The Scottish National Blood Transfusion Service has a survey to check whether people would be off by particular safety questions, when they change to a more individual risk assessment and end the "gay blood ban."

There is a "further comments" box at the end where I stated how concerned I was that they do not record sex and how this could be dangerous for male recipients of blood.

I'm afraid you do have to claim that you were assigned a sex at birth in order to fill in the form, but I think it is worth it to register concern. (And you can give your views on the new questions, which will be useful for them.)

forms.office.com/Pages/ResponsePage.aspx?id=veDvEDCgykuAnLXmdF5JmlzH8qINKktKqrArlDYS4NdUNDNEVEZKWjhTN0MwWEtITzlOSURPWUIwSC4u

It's bonkers.

www.mumsnet.com/Talk/womens_rights/3584176-NHS-Blood-donating-form-saying-gender-not-sex

www.mumsnet.com/Talk/womens_rights/3747649-Blood-donation-record-states-my-gender-is-female

www.mumsnet.com/Talk/womens_rights/3065980-Males-at-risk-from-female-blood-transfusion

www.mumsnet.com/Talk/womens_rights/3372218-Identifying-as-female-to-sell-blood

www.mumsnet.com/Talk/womens_rights/3208436-Could-this-be-harmful-dangerous

Where does this sit with the rules around donation frequency? Men are able to donate more regularly than women.

The higher haemoglobin concentration of men, compared to women, is related to testosterone levels. As part of the gender reassignment process the sex hormone levels are changed so that a woman who becomes a man will receive testosterone. This will result in the haemoglobin concentration rising to the higher range seen in men. The opposite will be true if a man becomes a female.

Apart from the really odd phrasing here (“if a man becomes a female” - clearly this is written by someone who has little medical knowledge or is so steeped in cognitive dissonance that they have lost sight of reality) the fact is that levels of testosterone in males are not reliably or even often reduced to female levels. So there’s a clear problem with this policy unless sex is irrelevant... and if that was the case it wouldn’t be mentioned as there wouldn’t be an issue.

www.medscape.com/viewarticle/893280

I'm really hoping someone will turn up in a bit with the science and this isn't as mad as it sounds, because surely, it can't be? Leaving aside the alarming insanity that haemoglobin will hopefully obey choice and preference (and artificial hormones) as opposed to reality, so lets dance until the medical disasters and court cases start..... gosh that's a fashionable approach at the moment....

I'm not eligible to give blood for several medical reasons, one of which is the medication I have to take to manage a condition.

Should someone who is taking a lot of medication to fill their body with artificial hormones - the full lifelong effect of which isn't really that well known, and the painful, dangerous sort of downsides rarely admitted to, particularly for people born female - really be giving blood full of that medication anyway? Is this a responsible thing to do?

Men who have sex with men are high risk
Not inherently - a monogamous HIV-negative male/male couple has precisely zero risk (from their sex life). Hence why the current, arguably homophobic, policy has been reviewed and is changing this year so that once men have been in a stable relationship for 3 months the bar is lifted - see the link I posted.

[quote Cwenthryth]The HIV risk is a whole other kettle of potatoes though. There is an argument that there has been a strong element of homophobia in the restrictions on men who have sex with men as they stand. I (a woman for avoidance of doubt!) was once deferred for disclosing that I had had protected sex with a bisexual man. Despite having a more recent negative HIV test myself and evidence of it. The regulations are such that a monogamous gay male couple are essentially currently barred from donating, although that is changing soon
www.blood.co.uk/who-can-give-blood/men-who-have-sex-with-men/[/quote]
High risk groups absolutely should be barred. Men who have sex with men are high risk.